Methods and apparatus for treating or controlling medical, psychiatric or neurological disorders by application of modulating electrical signals to a selected nerve or nerve bundle of the patient, are recognized in the art. The majority of these techniques stimulate one or more nerves which terminate on the target tissue. For example, it is known to stimulate the phrenic nerve, which terminates on the diaphragm, to effect respiration. There are relatively few reports of methods and apparatus which function to stimulate the brain and thereby cause the brain to send signals to the target tissue. The prior art directed to this latter approach to treat or control medical, psychiatric or neurological disorders is directed to the application of electric signals to the vagus and carotid sinus nerves, using an implantable or external neurostimulating device.
The use of nerve stimulation to treat endocrine disorders is disclosed in U.S. Pat. No. 5,231,988, which states that electrical stimulation of the vagus nerve can treat the pancreatic disorders of hypoglycemia and diabetes mellitus.
The use of nerve stimulation to treat and control migraine is disclosed in U.S. Pat. No. 5,215,086, which states that selective modulation of vagus nerve electrical activity can treat migraine symptoms.
The use of a neurocybernetic prosthesis, including a pulse generator which generates electrical pulses, to control or prevent epileptic seizures, as well as treat various involuntary movements, is disclosed in U.S. Pat. Nos. 5,025,807, 4,867,164 and 4,702,254. These patents disclose electrical stimulation of the vagus nerve to treat involuntary movement disorders.
U.S. Pat. No. 5,269,303 discloses the application of an electrical stimulating signal to the vagus nerve to treat symptoms of dementia, including cortical dementia, subcortical dementia and multi-infarct dementia.
The selective stimulation of the vagus nerve to treat and control eating disorders in general and compulsive eating disorders in particular is disclosed in U.S. Pat. Nos. 5,188,104 and 5,263,480, which disclose electric stimulation of the vagus nerve as a means of treating obesity, bulimia or anorexia nervosa.
U.S. Pat. No. 5,330,515 discloses electrical stimulation of the vagus nerve to treat pain.
U.S. Pat. No. 5,335,657 discloses electrical stimulation of the vagus nerve to treat sleep disorders.
U.S. Pat. No. 5,299,569 discloses a method and apparatus for treating and controlling neuropsychiatric disorders including schizophrenia, depression and borderline personality disorder by selectively applying a predetermined electrical signal to a patient's vagus nerve.
A. Neistadt and S. I. Schwartz in "Implantable Carotid Sinus Nerve Stimulator For Reversal of Hypertension" Surgical Forum Volume XVII, Proceedings of the 22nd Annual Session of the Forum on Fundamental Surgical Problems, 52nd Clinical Congress of the American College of Surgeons, San Francisco, Calif., October 1966, Chapter V: Cardiovascular Problems, pp. 123-124, disclose an implantable carotid sinus nerve stimulator for reversal of hypertension.
V. Parsonnet; G. H. Myers; W. G. Holcomb and I. R. Zucker in "Radio-Frequency Stimulation of the Carotid Baroreceptors in the Treatment of Hypertension" Surgical Forum supra, pp. 125-127, disclose that radiofrequency radiation used to stimulate a carotid baroreceptor was found to lower the systemic arterial blood pressure in dogs, but that responsiveness was lost in long-term nerve stimulation.
T. K. Peters, H. E. Koralewski and E. Zerbst in "The Principle of Electrical Carotid Sinus Nerve Stimulation: A Nerve Pacemaker System for Angina Pectoris and Hypertension Therapy" Annals of Biomedical Engineering 8(4-6):445-458 (1980) disclose a closed loop nerve pacemaker system for electrical carotid sinus nerve stimulation.
C. Farrchi in "Stimulation of the Carotid Sinus Nerve in Treatment of Angina Pectoris" American Heart Journal 80(6):759-765 (1970) discloses effects of implanting and using a carotid sinus nerve stimulator to alleviate attacks of angina. Farrchi states that the treatment is not intended to affect the glossopharyngeal nerve.
A. S. Geha, R. E. Kleiger and A. E. Baue in "Bilateral Carotid Nerve Stimulation in the Treatment of Angina Pectoris" Angiology 25:16-20 (1974) disclose the bilateral stimulation of the carotid nerve to treat angina pectoris.
B. A. Meyerson and S. H.ang.kanson in "Suppression of Pain in Trigeminal Neuropathy by Electrical Stimulation of the Gasserian Ganglion" Neurosurgery 18(1):59-66 (January, 1966) disclose pain treatment by direct electrical stimulation of the trigeminal ganglion and rootlets via an implanted electrode.
S. Donoghue, R. B. Relder, M. P. Gilbery, D. Jordan and K. M. Spyer in "Post-Synaptic Activity Evoked in the Nucleus Tractus Solitarius by Carotid Sinus and Aortic Nerve Afferents in the Cat" J. Physiol. 360:261-273 (1985) disclose the electrical stimulation of the carotid sinus, aortic and vagal nerves, alone or in combination, and discuss the significance of their studies on determining the role of the nucleus tractus solitarius in cardiorespiratory reflexes.
U.S. Pat. No. 3,650,277 discloses a system for reducing and controlling the blood pressure of a hypertensive patient by electrical pulse stimulation of the carotid sinus nerves, and in particular, stimulation of an afferent nerve from a baroreceptor in an individual.
U.S. Pat. No. 4,573,481 discloses an implantable helical electrode assembly configured to fit around a nerve for electrically triggering or measuring an action potential or for blocking conduction in nerve tissue.
In general, the prior art recognizes that electrical stimulation of a patient's vagus nerve may provide beneficial effect to a patient receiving such treatment. It is also known that electrical stimulation of the carotid sinus nerve, which is a branch of the glossopharyngeal nerve, may provide therapeutic treatment to patients suffering from hypertension and angina pectoris.